Several knowledges about treatment of surgical jaundice

Abstract

The purpose of the present investigation is to acquire knowledge about factors influencing operative results of surgical jaundice. The authors analyzed the 259 cases with obstructive jaundice which were operated for the latest eleven years. The items of 259 cases were 78 cases with cancer of bile duct or head of pancreas, 117 cases with gall stone, 34 with inflammatory disease, 7 with congenital obstruction of bile duct and 23 with postoperative relapse of stomach cancer. The results obtained were summarized as follows. 1) The cases were classified by grades of jaundice as the cases of slight, moderate and severe jaundice. Among the cases with malignant tumors 62.4o{, showed severe jaundice and only 9.9% slight jaundice, while among the cases of benign diseases without malignant tumor only 8.6o/0 showed severe jaundice and 53.6% slight jaundice. 2) Operative death without one month after operation occured in 53 cases or 20.5%; 39.4% of the cases with cancer of bile duct or pancreas, 30.4~ of the cases with postoperative relapse of stomach cancer, 11 8% of those with inflammatory diseases and 7.7% of those with gall stones. Operative mortality of every operative procedures were 56% in exploratory laparotomy, 47.4% in pancreatoduodenectomy, 38.5% in construction of internal biliary fistulas and 21.2 % in external biliary drainage. 3) In the cases with gall stone, grades of jaundice were very important factors which influence operative mortality, while in thosc with cancer either of bile duct or of relapsing stomach cancer, grades of jaundice had no connection with mortality. 4) The cases of postoperative deaths were general prostration in 12 cases, cardiac failure in 11 eases, hepatic coma in 9 cases, peritonitis in 7 cases, massive bleeding in 6 cases, pulmonary complications in 2 cases and tile other in 6 cases.